Abstract:
INTRODUCTION:A patient undergoing renal transplantation presents unique problems to the anesthetist, as almost every body system is affected. The combined spinal-epidural technique has become popular in lower abdominal surgeries because it offers the advantages of both spinal and epidural techniques. We review our experience of combined spinal-epidural technique in patients undergoing renal transplantation with respect to demographics, intraoperative anesthesia, hemodynamics, postoperative analgesia, and untoward adverse events. MATERIALS AND METHOD:Fifty consecutive patients scheduled for elective renal transplantation over a period of 4 months who consented for combined spinal-epidural anesthesia were enrolled in the study. Combined spinal-epidural anaesthesia was performed using a double-space technique in the right lateral position. Intraoperative monitoring included electrocardiography, pulse oximetry, noninvasive blood pressure, central venous pressure, and urinary output after clamp release. Intravenous fluids, colloids, and blood products were infused so as to keep the central venous pressure between 12 and 15 mm Hg. Postoperative analgesia was provided with buprenorphine via an epidural catheter. We noted intraoperative and postoperative complications. RESULTS:Neuraxial blockade was satisfactory in all but four patients who required supplementation with general anesthesia for unduly prolonged surgery. There were no significant intraoperative hemodynamic changes. The total intravenous fluid used during surgery was 64.24 +/- 12.3 mL/kg. During the postoperative period, all patients had good postoperative pain relief with no incidence of epidural hematoma. CONCLUSION:Combined spinal-epidural anesthesia proved to be a useful regional anesthetic technique, combining the reliability of spinal block and versatility of epidural block for renal transplantation.
journal_name
Transplant Procjournal_title
Transplantation proceedingsauthors
Bhosale G,Shah Vdoi
10.1016/j.transproceed.2008.03.027subject
Has Abstractpub_date
2008-05-01 00:00:00pages
1122-4issue
4eissn
0041-1345issn
1873-2623pii
S0041-1345(08)00231-5journal_volume
40pub_type
杂志文章abstract:BACKGROUND:From 1968 until 1997, transplantation-related activities were not properly regulated and were informally practiced. During 20 years, many legal and political changes influenced it. OBJECTIVE:To provide a historical overview of the 20 years with a descriptive data analysis of a 20-year data set. METHODOLOGY...
journal_title:Transplantation proceedings
pub_type: 历史文章,杂志文章
doi:10.1016/j.transproceed.2020.01.075
更新日期:2020-06-01 00:00:00
abstract::The data assessing the prognostic value of peak exercise oxygen consumption (VO2) in heart failure (HF) patients is largely derived from cross-sectional studies in which medical therapy was not maximized in all eligible patients and no clear explanation was given as to why such was the case. To assess the relative pro...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2006.02.099
更新日期:2006-06-01 00:00:00
abstract::Advances in the surgical techniques, preservation solutions, and methods for predicting eventual long-term renal function from expanded donors will be critical in allowing precise selection criteria for kidneys for transplantation, resulting in the optimum use of a scarce and precious resource. Until other options suc...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/s0041-1345(98)02044-2
更新日期:1999-02-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:HLA matching at the A, B, and DR loci influences the graft survival rate of deceased donor kidney transplants. The effect of HLA-DQB1 matching on transplant outcomes is still controversial. The aim of this study was to investigate the association of HLA-DQB1 matching with allograft outcomes in...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2018.02.187
更新日期:2018-10-01 00:00:00
abstract:INTRODUCTION:In our clinical context, there are two groups that practice blood purification treatments on acute or chronic liver failure (AoCLF) patients: one group used MARS (molecular adsorbent recirculating system) and the other Prometheus. MATERIALS AND METHODS:The MARS group used the lack of response to standard ...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2008.03.069
更新日期:2008-05-01 00:00:00
abstract:PURPOSE:New-onset diabetes mellitus (PTDM), a major metabolic complication after renal transplantation, examined for incidence and risk factors. METHODS:The records of 358 renal transplant recipients with functioning grafts, from 1986 to 2006, were categorized into two groups according to the usage of tacrolimus (FK):...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2008.06.034
更新日期:2008-09-01 00:00:00
abstract::Tuberculosis (TB) is a serious infection in immunocompromised patients, such as solid organ transplant recipients and HIV-infected patients. The diagnosis and treatment in this population present several challenges because of the aspecific clinical manifestations, the difficulty in diagnosis, and the choice of the mos...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2011.02.050
更新日期:2011-05-01 00:00:00
abstract::Mycophenolate mofetil (MMF), in combination with cyclosporine and corticosteroids, improves long-term graft survival in renal transplant recipients. However, optimal MMF therapy may be limited by gastrointestinal (GI) intolerance, which may result in the need for MMF dose reduction, interruption, or discontinuation, l...
journal_title:Transplantation proceedings
pub_type: 杂志文章,多中心研究
doi:10.1016/j.transproceed.2004.01.037
更新日期:2004-03-01 00:00:00
abstract:BACKGROUND:Currently, pancreas transplantation has been a promising strategy to restore long-term normoglycemia as well as to improve life quality for patients with insulin-dependent diabetes mellitus (DM). However, the discrepancy between the number of organs needed and the number donated for transplantation is always...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2017.11.001
更新日期:2017-12-01 00:00:00
abstract::There are few reports of combined heart and liver transplantation (CHLT) for familial amyloidotic polyneuropathy (FAP). The technique for the operation remains to be defined. Four CHLTs were performed for amyloidogenic transthyretin-related (variant Glu89Gln-ATTR Glu89Gln) cardiomyopathy in our center. Patients 1 and ...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2004.03.076
更新日期:2004-04-01 00:00:00
abstract:OBJECTIVE:Bone loss and bone fractures are disabling complications after heart transplantation. Severe bone loss happens mainly during the first year posttransplantation. Steroids and cyclosporine alter bone metabolism in several ways. To counterbalance these effects, antiresorptive therapy is provided to these patient...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2007.07.063
更新日期:2007-09-01 00:00:00
abstract:BACKGROUND:That hypertension (HTN) as a leading cause of end-stage renal disease (ESRD) is linked to sleep disorders in the general population can be the basis of a hypothesis that HTN may be a contributing factor to the poor quality of sleep in some kidney transplant recipients. This study was designed to investigate ...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2007.03.011
更新日期:2007-05-01 00:00:00
abstract:BACKGROUND:We evaluated the outcome of combined liver-lung transplantation (L-LTx) in cystic fibrosis (CF) patients with liver transplantation (LTx) for CF liver disease. METHODS:The United Network for Organ Sharing (UNOS) data were analyzed from October 1987 to August 2009. RESULTS:Of 294 patients (210 children), 26...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2012.02.033
更新日期:2013-01-01 00:00:00
abstract::Outflow obstruction may lead to liver congestion and eventual graft failure after living donor liver transplantation. Various methods of venoplasty provide wider outflow tracts. Most series have suggested use of autologous or allogenic grafts for patch venoplasty. We used a polytetrafluorethylene patch in two patients...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2008.07.035
更新日期:2008-10-01 00:00:00
abstract:INTRODUCTION:Liver transplant is the only option in reversing liver insufficiency and its complications. It is very important to realize the quality control of organs and tissues used in transplant, as well as to develop diagnostic, treatment, and prophylaxis techniques to prevent other comorbidities and to increase th...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2020.01.073
更新日期:2020-06-01 00:00:00
abstract::The primary cause of morbidity and mortality in renal transplantation is cardiovascular disease. Increased oxidative stress implies a greater degree of atherogenesis in these patients. N-acetylcysteine (NAC) which has a thiol group that is the source of l-cysteine and reduced glutathione, acts against atherosclerosis ...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2008.08.109
更新日期:2008-11-01 00:00:00
abstract:INTRODUCTION:The EuroTransplant "old to old" program establishes that patients older than 60 years can receive offers of organs from donors older than 60 years. The compromised function of these organs makes it a priority to preserve their initial kidney function. HYPOTHESIS:Calcineurin-sparing protocols using anti-IL...
journal_title:Transplantation proceedings
pub_type: 临床试验,杂志文章
doi:10.1016/s0041-1345(03)00379-8
更新日期:2003-06-01 00:00:00
abstract:BACKGROUND:Primary pulmonary hypertension can lead to hypertrophy of the right ventricle and ultimately to its insufficiency. Lung transplantation remains the only viable treatment for patients with certain forms of this disease. Usage of extracorporeal membrane oxygenation in veno-arterial form (VA-ECMO) after transpl...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2020.02.113
更新日期:2020-09-01 00:00:00
abstract::Voriconazole is currently contraindicated for use with sirolimus. We report our experience with voriconazole/sirolimus in two renal transplant recipients. To our knowledge, this is the first experience with voriconazole/sirolimus. An interaction requiring a 75% to 87.5% sirolimus dose reduction was noted, but goal tro...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2004.09.043
更新日期:2004-11-01 00:00:00
abstract:BACKGROUND:Hypertrophic cardiomyopathy (HCM) is a genetic heart muscle disease characterized by asymmetric or symmetric ventricular hypertrophy in the absence of an obvious clinical cause. Orthotopic heart transplantation (OHT) has been performed in patients who have refractory symptoms despite medical therapy and surg...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2013.12.052
更新日期:2014-06-01 00:00:00
abstract:OBJECTIVE:Our aim was to safely and effectively reduce adverse gastrointestinal (GI) events resulting from the use of mycophenolate mofetil (MMF) in liver transplant patients by switching to enteric-coated mycophenolate sodium (EC-MPS). PATIENTS AND METHODS:We studied 19 patients on maintenance therapy presenting with...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2009.06.004
更新日期:2009-07-01 00:00:00
abstract::Acute liver failure (ALF) counts for 9%-11% of activity in leading liver transplant programs. We have summarized the Hungarian Liver Transplant Program experience for ALF among 412 consecutive orthotopic liver transplantations (OLTs). All OLTs were performed without an extended international donor background. The prop...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2011.03.076
更新日期:2011-05-01 00:00:00
abstract::The shortage of available cadaveric organs for transplantation and the growing demand has incresed live donation. To increase the number of transplantations from living donors, programs have been implemented to coordinate donations in direct or indirect form (cross-over, paired, and domino chain). Living donors with c...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2013.07.026
更新日期:2013-09-01 00:00:00
abstract:OBJECTIVE:We compared single-shot epidural analgesia (20 mL 0.125% levobupivacaine and 3 mg diamorphine) followed by regular tramadol versus morphine patient-controlled analgesia (PCA) for postoperative pain following donor nephrectomy. METHODS:We retrospectively evaluated 12 patients who received single-shot epidural...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2011.08.116
更新日期:2011-12-01 00:00:00
abstract::The cyclosporine (CsA) blood concentration at 2 hours postdose (C2) has been shown to be better than trough level (C0) to predict acute cellular rejection (ACR) in solid organ transplantations. We tried to assess the superiority of C2 monitoring to C0 in heart transplantation (HTx). Prospective data were collected fro...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2004.08.115
更新日期:2004-10-01 00:00:00
abstract:OBJECTIVE:To evaluate the success of ureteral stent placement to treat or prepare for surgical treatment of urologic complications after renal transplantation, according to a type of ureteral anastomosis. PATIENT AND METHODS:From May 1989 to December 2006, we performed 703 kidney transplantations including 412 extrave...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2009.08.046
更新日期:2009-10-01 00:00:00
abstract:BACKGROUND:Obesity has been related to poor renal graft function. The aim of this study was to compare the long-term graft outcomes of living-related kidney recipients regarding donor-to-recipient body mass index (BMI) parameters using the old Quetelet BMI formula and the new Trefethen BMI formula. METHODS:From Novemb...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2013.12.029
更新日期:2014-01-01 00:00:00
abstract:BACKGROUND:The shipment of human islets (IE) from processing centers to distant laboratories is beneficial for both research and clinical applications. The maintenance of islet viability and function in transit is critically important. Gas-permeable silicone rubber membrane (SRM) vessels reduce the risk of hypoxia-indu...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2014.06.002
更新日期:2014-07-01 00:00:00
abstract:OBJECTIVE:Simultaneous pancreas and kidney transplantation (spktx) is the multiorgan transplantation. Thus various complications originated from transplanted organs and the complications that are not directly related to pancreatic or renal grafts could be developed at the same recipient. AIM:The aim of this study is t...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2016.01.091
更新日期:2016-06-01 00:00:00
abstract:BACKGROUND:Systemic immunoglobulin light-chain amyloidosis (AL) is a plasma cell dyscrasia resulting in multisystem organ failure and death. Autologous hematopoietic stem-cell transplantation (ASCT) has been widely used to treat patients with AL. However, treatment-related mortality remains high and reported series are...
journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2014.09.053
更新日期:2014-10-01 00:00:00